3938 Blackhawk CirCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3938 Blackhawk Cir
Lot: 10 Block: 9 Addition: Cedar Grove 8th
PID:10- 16707 - 100 -09
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments: P
Fee Summary:
Valuation: 3,000.00
Contractor:
Krech Exteriors Corporation
5866 Blackshire Path
Inver Grove Hgts MN 55076
(651) 688 -6368
ctures are not acceptable in lieu of inspections.
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Construction Type:
Occupancy:
Owner:
Corey R Baisch
3938 Blackhawk Cir
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
$90.00
Issued By: Signature
Building
EA079969
09/24/2007
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3938 Blackhawk Cir
Lot: 10 Block: 9 Addition: Cedar Grove 8th
PID:10- 16707 - 100 -09
Use:
Description:
Sub Type: e- Siding
Work Type: Siding
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Krech Exteriors Corporation
5866 Blackshire Path
Inver Grove Hgts MN 55076
(651) 688 -6368
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Construction Type:
Occupancy:
When installing ventilated soffit material, remove existing soffit mate
take steps to ensure maximum ventilation into attic space.
Owner:
Corey R Baisch
3938 Blackhawk Cir
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
al (i.e. debris that could block vent openings) and
$88.50 0801.4085
$1.50 9001.2195
$90.00
Issued By: Signature
Building
EA081360
12/06/2007
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
CITY OF EAGAN Remarks Wtr con nd. on 9-19-72
Addition Cedar Grove #8 Lot 10 Bik 9 Percei 10 -1 {707 1 nn09
Owner ? °`< street 393$ B1aCkhaWk C1x'Cle State Eag251,1'+N 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUR F.
STREET RESTOR.
GRADING
SAN SEW TRUNK 5' 1970 125.00
SEWER LATERAL ZZ-?-
WATERMAIN
?. WATER LATERAL 1
WATER AREA
? STORM SEW TRK
STORM SEW LAT 1974
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 300.00 6 9-19-72
BUILDING PER.
sAC 260 00 6 6 -1 n72
PARK
w '
T0: IiId 0F EAGAIJ 1795 Pilot &iob i:oad
Engan, Ni:innesoCa 55121
PEP.NIIT N0. ?E2
The Board of Supervisors hereby grants to Cedar Grove Construction Co.
of 7343 COIiCOS'd $ZPCl. ICast. South 5t. paul 55075,
a PLUMBIM Permit ior: (Owner) same
? 57:-?-%' fj-arne-Um A -3-f,- i$54-aarnei#sn-??? E6?--?ad
, e_4m5-7, 3? -Rtv'ertc?- 6-?,
I?' ?;?,,3...Motit.i?}?,3-f,-R? Rlz,-? 1nt to apNlication dated
?TJ!?`+ VwtV.rl
-- 7T?"7?2 •
1 ee Paid:_ %1h0.Qp llated this 19ba day of SBFtgmbax• , 19-2z.
3.50 s/c Building Inspector
(P
r v - 9 -r
4
TQ'. U OF EAGAid
"795 Pilot Kuob i;oad
Eagan, Ninnesota 55121
PEMIT N0. 2?11'
The Roard of Supervisors hereby grants to Cedar Grove Cortstru.C+,ion Co.
of 7343 OCalOOrd B7.Vd. E., 3outlz St. Paul 55075
a liLATIl'G Permit for: (Otiner) same
1870 o,unel.j.?n 1 3-7, 1654 Carnal.ian 2-7, 1862 -5-7$ 2 i3lverton 6-5-8,
at 1773 Mcantic3y38 bla,ckt,awk U. 10 7,9*1suant to application dated
1738 aartell 16-10-8
_ 9/1 /72 i ee Paid: ,;,1 L0.w Dated this I9th day of Santmnhar
3.50 Slc
BuiZding Inspector
t
I EAGAN TOWNSHIP
BUILDING PERMIT
Owner ........ ?....... ?=?---••.•-•--.._....•--------••••-----•-•---......
Address (Psesen!) ....? 13 cP ........ . ...........•--............--•-------••L?,
Builder ....._.....y..:...................................................................
Address ....-•-••-----------------------•---....----•--------••.--•----......__....-•-------......••--
DESCRIPTION
x? 3149
Eagan Township
Town Hall
na:e ..... lIO.::3.-7.3
..................
6loriea To Be Used For Froni Deplh Height Est. Cos3 ' ermit Fee Remarks
10 -2-0
0 .3, a--v
'S-U 15 ,5-1 ,?.?2..?. ?•--?_
/&
° LOCATION -K.S`a
Stieet, ROad or other DesCiipiion oi Loeatton I Lo! tsloeK Aaauion o! -rraei
This permit dces aot suthorise the use of stseets, roads, alleps or sidewalks nor does i3 givs the ovPnas os hfs agant
the right to create anp situation which is a nuisance or whieh presenls a haaard !o the heallh, safelp, conveniaace and
geaeral welfare !o anyone in the commuaity.
TFIIS PERMIT MUST BE KEPT OPi THE PREMISE WHILE THE WOAK IS IN PROGAESS.
This is !o certify, lhat.... 13 . ..... ??!-----••-••- ...... •-•••................... has pe:mission to erect a-• 1.t.,.?:?'.•• .. .-?--? upon
the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopied April 11,
1955.
?
-?------•--...•• .
•-•• ..........................'_....._. .t`.'-?-•' ••-----?-• --?•••--....... .?....•-- .. Per ....._..••-•••-•-- .. .. .--- •---
? Chairmaff of T?wn ••Boa`y rd' Build3nQ Inspecto: .........................
-va
? dS
?- - -
EaGatv -rowNs Hi P
BUILDING RERMIT
Owner .....-?rt?---••-'-`?`'?-'? ?r •-----
••------------•-•----•.......°--------.... •
Addsess (present) --••?•:---?........ 6!'? .••-•-••-...---•--•----•--
Suitder •---- ----------------•-----•-••-•--------..............-...................................
Address ............. •-•................ •----............... ------------ ... ........................
DE5CRiPTION
N? 2850
Eagan Township
Town Hall
_ ? Z..
Daie
------ ` -•• .....°......... .................
Stories To Be L)sed For Front Depth Height Est. Cos! Permi# Fee Remarks
?? X-T
LOCATIDN 67.2-7 3 U
Street. Ftoad or ather Deacripfion of Loca2ion I Lo! oek Addi3ion ur Trac2
e. a -7,
ry b` ;k i6 03-Q ?_ • -? -g'
This permi2 daes aot authorise the use of slreeta, :oads, alleys ox sidewalks nor does it give the ownsr or his aqent
the right to creale anp situation which is a nuisance or which presents a hazard to the health, safetp, convaaience and
general welfare to anyone in the community.
THIS PERMIT MUST BE ?KE"PT ON HE PREMISE WHILE TFIE WORK IS IN PROGRES .
This is to certifp, ?_...?t?--.......?as permission !c ereci a....?---:-••_•-•---• upoa
• • • • • --------- ..
!he above descrilaed premise aubjeci !o the provisions o# the Building Ordinance foA Eagan T waship adoptad Apri] 11,
1955.
/?
-••--•••••-?---........... >..._._........................ ....••• Per ....... -...... ,N'"`.:....?.._?........
................ •.........................................
--?
Chairman of Tnwn Board BuildinQ Inspector
`s ,0?5
2005 RESIDENTIAL MECHAATICAL PERMIT APFLICATIC)N
City Of Eagan
3830 Filot Krrob Raad, Eagan MN 55122 '
Telephone # 65I-675-5675
Please camplete far: single family dwellings & tnwnhameslcondos when permits arre required for e,ach unit
Date
i# #
U
Site Address _
n
tz rj
`
t
O
P
hane #
Tele
wner
roAer
Y p
Contractar
STANDARD HEATiNG 8 AIR Ct1NDITIONING CO.
Street Address 410 Wr-ST bKE STREET C'ty
MIMlVEAFQLIS, MN 554W-29M
S#ate ZiP Telephone #
Bond #• Expires:
Tbe Applieant is Owner Contractor Qther
Add-an or alterativn ta elcisting dwelling unit ? 30•00
furnace Additional -Replacement
air exchanger
t
l
Y
acemen
air canditioner New
Ytep
other
State Surcharge .50
Tatal
Ihereby apply for a Residential Mechanica! Permit and acknowledge tha# the infarmatibn is camplebe and aceu.rg.`Ce; tha# the w!ork will
be in conformance with the ordinances and codes of the C'ity of Eagan and with the Mech-anieal Codes; that I undec?mW this is not a
permit, but only an application for a rrnit, attd work is n t to srova. tart witho that the ?ror ia? a?tce with the
appro r plan in the case of wnrk quires a review d appl af ans.
Ap liea.nt's Printed Name Applicant's Signa e _
, ? JUN 1 6 2005
? 2045 CUMRMRCLkLMUMAMCALT ° APP?CATION,
'Cft
3830-MotKnoir:kancl,?agam:?W M22 Telephone #`651=6954675
Please complete for. conarnerciaVinQustriW buiktings
mu}ti-famely buildinp when soperaW perrpits ae M requi,rod f+ar ewh dwo[ting usi# : .
Uate _ : . !
Sitc Stree# Address Unit #
.,
Tenant Name (if applisabte) Prvviww Tetait Name ..
, ? . ;.
Property [1wner T T#
Contractor
StreetAddress 'ri n??C;i;??
5tate Zip
BOlld
The Applieant is Qwmer Cotitr?+ctor dthee
Wor#'Iype ., , ..:..:
Mew Gonstivction Undeqrountf TSM i r%W -Rerwve
_ tnterior Improvement i.now. P49raq .,,_Ptmssed.,: ,:?..,Gias .
Naturo of Wortc:
x. . .
""en InsfalNnglr&MVIn? ?ndoMmund ft* ca W*wpedkar by 1'lr? XOWW arrd A[opbing 41*6?ftr t ,
Permit Fees: s70.50 UAdergrou,d tm* inuutlatio3lMW4VW .
SSt1.59i Afinknum (incleft Stw sumberp)
. or
Conha.et Value $ _ x 1% ° $ patnrt ?
• If aLem?it te is $1,000 or less, acld $.54 ? $ Suft Surcharge '
if ?rmit fee is rrver $1,4K add $.50 -fiir _
every $1,0QQ pam*fee Prte. ;
Iherehy apply for a Comrnercial Mechmica) Pemk Kd acl?00,?jWige thg de Unformmtina is<compte" and ac%ww; ?t Ihe'wrxk
will be° in conformance witkt tha ordinenc+es and t;ades 40thei t%y af F,npn antl with the INedmicW C+Ddes; Ehat Ilaukt*tVad *is is
nvt a permit, but onty an appiication far,a permit? &nd,?:k-not t,i ?t witout a pe?mit;. ?at tFie ?aro? will b,? in ?e ?rith
the npprovad plan in the caso,,vfwork which reqWMxftViIVWand approval-nfplaw: .
ApP[ica.nt's Printed 1+1ame
Appraved By:
1999 BUILDING PERMIT APPLICATION (RE51DENT1AL)
ciTr oF EAcAa
3830 PaoT KNcB Rv - 55122
Hew Cansiructton Rrauhements
D 3 regisFered site surveys showbng sq. tf. af int, scf. ff. of house and y,i raofed aeas (20% rr?aximyM, laf caveraae albwad)
Y 2 tapies af piarts (show bepm & window ahe3; poured htd. desEgn; etc.)
> 1 5Bf Of @AB Cd? krHOlIS
> 3 coples of e ation pbn N iot plcelted cftr 7/1 /93
aaTE: 5 f3
DESCRIPTIQN OF WORK:
12madel/loorcR re+!
2 capba of plan
1 set of eTYelgy CCIktlbCtklels fo[:?dCN1o11S
1 slfe stxrey far exterior vddo? & doc1cs
C4N5TRLiGTION CQSt: Z-??. =-r.a
--
? ?
sTREEr ADDaEss: -5Z36
Eof: aLaeK: suga./P.i.o. #: a. GY 0 U?
?
Phone #:,?5-/ ^ 4 S - 0 C1
PROPERTY last
OWNER ?
Street Address•
rirst
+F, e
Ciiy !`r,ae A,-k-J StCtte: Iip: S".` t2 'Z- _
,
Company: <? 2 ? ?`9 ??' ane ?: ?? [flr?oi -ti??)
CONTRACTOR
Streef Address: ? Ucenso # €acp.
CHy State:
Yip: ?
ARCHITEGf/
ENGINEER Company: Mame:
Tefephone #: atea code { }
Street Address: Rsgistrofion ----
City State: Zlp:
Sewer & water Ucensed plumber [reaulrrd for newcanslruction Qnlvl:
Penalfy applies when addreu change qnd IQt change is requested once pemdt is issued.
I hereby acknowledge that I have read fM3 applicafion, sFate that the iM c , cand ta comply wffh aR appbcabl
$kate af Mianesota Statvtes and Ci1y of Eagan Ordinancas.
3ignc+ture of Appli .
aFFIce usE ONLY .
Geffftates af 5urvey Received Yes No MAY 1 31999
Tree Preservation Plan Received Yes Na Not Required i. .ei??'.s/ .-
•,
OFF1GE USE QNLY
?
BUILDING PERMIT TYPE
E3 01 Foundatian 0 06 4-plex ? 'I'1 10-plex C] 16 Fireplace 0 21 Porch (3-sea.)
0 02 SF Dwelling 0 07 5-plex ? 12 12-plex 0 17 Garage 13 22 Porch/Addn. (4-sea.
13 03 1 of _ plex 0 08 B-plex ? 13 16-piex CJ 18 Deck C7 23 Parch (screened)
? 04 2-plex ? 09 7-plex O 14 Apartments 13 18 Lower Leve! ? 24 Storm Damage
C7 05 3-plex ? 94 8-plex E3 15 Lodging ? 20 Paoi 0 25 Miscellaneaus
woRK nrPE
D 31 New
( 0 35 Tenanf Impr 0 39 Gas Line Qnly C] 43 SidinglSoffitslFaseia
32 Addition
,%: ? 36 Move Bidg. 13 40 Gas lnsert Cl 44 WintlowslDoors
13 33 Alteration 0 37 Demolish Bldg * ? 41 Waod Stove 0 45 Fire Repair
D 34 Repair ? 38 Demolish (lrrterior) E3 42 Reroof
* Givs PCA handout to appticant for demalitian permit
GENERAL IMFORMATION
Const. (Actual) Basement sq. ft. Census Cade
(Allawable) Main levei sq. ft. SAC Code 41
UBC Occupancy sq. ft. ? No. ofi Units ?/
Zoning sq. ft. Na. of Bldgs ?
# of Stories sq, ft. MC1ES System ?
Length sq. ft. City Wa#er
Width Faotprint sq. ft. Baoster Pump
RRV
74
I1 3'73 -7
S
e
?.Q
Fire
.?
prinkler
d ?
APPROVALS A'LLQ?7 ? 7g?
Plenning Building Engineering Variance
Permit Fee Valua#ion: $ ? Qp?
Surcharge 14,0
Plan Review. 61M f?',?
License
MClES SAC
1 LI X-3'y ?. lf 7? ?!?? 7f'??
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
SNV Surcharge .
Treatment PL .
Park Ded.
Trails Ded. '
Other
Copies
Total:
SAC Units
% SAC ?
. .a
;
? .•, .
?
?
_.
? . .
•y.. ?i ? . . .
? ;?jt .
:'.
? •+•? ?
..
?. •
. .? _ ?
•
',:;}• ,
' • .1` ..
''.3
,4,T
•'•.'
- }?
' ? I
Csta: OS/iEY98 Zims:1,33:0s PN
Fmff. Kun pant To: Fawoosom
Lft.dMRS•??
?? SM22 ,
- Propwty Addrets: $11*6 BLACKHAWK CiRGLB. rcAQAN
aRUM
LoQat LOT 10. flLtyCK 9. CEDhR aROVE NO. •
aDRAW1htG
rnsp. aot.: 413196 imp• Br: PcT
?
?• - ?a
?
?
r (o Tivs PCCn+ sc4-6,-,llV-
.66M s44. Lot- f trie.
r 13LACKV4AWK
IFtCLE
r 3 9 3 q S
Skaa 1a f\b 4- fucccd 'L,-1
v
ftK=A uO AJd,4u, :-
._ . . , ? _ . ,
. _.. ,__. . _,-,-
? ?n
CITY"OF"EAEAN PERMI7
3830 P'ILaT ?.`NOB RD
EAGAN, MN 55122
651-681-461?
??? an
B-A-L-f-5 "-#f-T
?X,9x
@@3`*w21.
F,ff: 06
(D IYPE: OSA
TR TYPE: P{?
I
DAff. 1W 17, 99 1923:14
TQTAL $157.25
W: 491=57M EM NA1
AP: 017259
??: 0 T MM
ANDfOR SMICES It4 'Eff APlM CF TIE
`iUAL " huo a Vulal il? ?
TILE OBLM?..`TrM ? F`? ? THE
IMEW; a 1: iT I9M
a.??::; F . tSt!{6 VISp
?
?jpo
460-50
1999 FtREPLACE PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD - 55122
651 68 l -4675
Date:
Description of Work: _ Construct new fireplace _Gas Masonry Alterations to existing
_ Install gas insert only Install gas li?:e oi:l,y
?C Other ?i?--!9? _ 40,o 146 4-
Job address:
Lot: 1 b Block: 1 Subdivision/P.I.D. #: ?.Cµl?1 ,(??? ? lJ
Applicant (circle one only): Owner oPermit Fee: $60.50
P
Name: Phone #: g?T_66?1"
PROPERTY Last First
?NVNER ?"/ c??
S?eet Address: ;
City State: Zip:
Company: Phone #:
(area code)
FIREPLACE
INSTALLER
Street Address: - (j
City ?W V `! l? State: Zip
Company:
GAS LINE
INSTALLER Street Add
? City
Phone #:
(area code)
State: Zip: _
I hereby acknowledge that I have read this application and state that the information is correct and agree to
comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature
OFFICE USE ONLY
BUII,DING PERMIT TYPE
? 16 Fireplace
WORK TYPE
? 31 New
? 32 Addition
? 33 Alterations ? 39 Gas Line ? 41 Wood Stove
? 34 Repair ? 40 Gas Insert
GENERAL INFORMATION
Census Code 434
SAC Code 01
REMARKS
Chimney/flue must be inspected before concealing.
*
,
CITY USE ONLY
L_/ L9 BL 9 RECEIPT #: rT ??-?-ff
SUBD. ?ojj"44.. v " RECEIPT DATE: Y LI2%
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 6814675
Piease complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES EACH TOTAL
Shower 3.00 x =
YJaier Cioset 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet * minimum - 1 • 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwellings under construdion 5.00 X =
Water Softener " for existing dwelting 20.00 x
U. G. Sprinkler ` for dwelling under const. 3.00 =
U.G. Sprinkler * for existing dwelling 20.00 =
Alterations " to existing residence 20.00 =
Water Tum Around 20.00 =
Private Disposal System " Dak Cty lic. 75.00 =
(new and refurbished systems)
Private Disposal Systems * Abandonment 20.00 =
STATE SURCHARGE
TOTAL
.50
X•5(-)
I hereby adcnowledge that I have read this appacation, state that the iMortnation is camect, and agree to comply with all applicable City
of Eagan ordinances. R is the appliqnt'e responsibility to notiy the property owner that the City of Eagan assumes no liability for any
damages caused by the City during its nortnal operational and maiMenance acdvities to the facHibes construdeci under this permit within
City property/right-of-way/easement. ?? ? ? ? I NOY
SITE ADDRESS: 39:38 13"'???? ?IFELE
EMM4 , 55122
OWNER NAME: H 4152`3573 14
INSTALLER NAME:
STREET ADDRESS:
CITY:
TELEPHONE #:
DBH VEN TCO/ARPLIArJCE itvSTALLERS
2SnS r4RFIELD7AVE3 SOUTH
tvI;PJNEAF'OLIS. MN 55408
STATE: ZIP:
?
?
SI URE OF PERMITTEE
CTTY USE ONLY
LQT tO BL ? RECElPT `-t'
SUBD. &Ac.lil RECEIPT DATE: 1 - E I
MECHANICAL PERMIT # '_3 116 ?L
1999 MECELAN1CAL PERMIT (RESID£NTiAi)
crrrof EAsArr
3830 Pu.ar xNos Rnn
kkCaM MN 55122-
(8.51) 661-4675
Date•
Complete t}xis section onlv if yau are insta.lling HVAG in a single family dwelling; townhome or condo u er
construction and not owner loccunied.
• HVAC: 0-1U0 M S T U
AUIyITII?NAL 50 ivI BTIi
* Gas outtets (minimurn of one required @$3.00 ea.)
State Surcharge
Total
$ 30.00
6.00
.sa
$
Complete this section ortlv if you are remodeling, adding to, or repairing an existing single family dwelling,
townhome, or condo. Please indicate if it is a new item, alteratian, or repair.
New Alteration ? Repair _ Other
Reminder.? Ca11681-4675 for cnspectians.
-,>( Furnace
Air conditioning
Air exchanger
SITE ADDRESS: ?? f CCc'
Other
$ 30.00
State Surcharge 0
Minimum Total Due 3b.5 ?
?. .. _ _.
OWNER NAME: Lcl/'f 1 ?? L( r'Yl pHONE #: '?s-
INSTALLER NAME: i?i1?d?F€o?EK??'s A"`? Aln c? ,, - (AREA Ct3DE)
7 7 PHONE #:
?91FIPr+??s3, (AREA CODE)
STREET ADDRESS:
CITY
CtTY USE ONLY
L BL RECEIPT #:
SUBD. RECEIPT DATE:
APPRQVED BY: , INSPECTOR MECHANtCAL PERMIT #:
1999MECiiM1CAL PMII'i' (CAMMERCiAL)
c['TY OF EAeAN
3$34 PILC1T KNOB RD
£A6M, NllN551 28
(651) 6$i-46?5
Piease camplete for: ali eommerciailindustrial buildings
multi-famify buildings when separate perrnits are not required for each dwelling unit
DATE: CONTR.ACT PRICE:
WORK TYPE: New eanstruction Install U.G. Tank
In#erior Irnprovernent Remave U.G. Tank (Minimum Fee)
Processed Fiping (Minimum Fee)
**AT(OTE: When installing/rerrsoving underground tank, ca11651-681-4675 for inspection by fire marshal
and plumbing inspector.
DESCRIPTION OF WORK:
FEES: 1°10 of contract price Q,R $30.00 ueiaimum fee, whichever is greater.
CONTR.ACT PRICE x 3%
PERMIT FEE
ST'ATE SURCHARGB
TOTAL
SITE ADDRESS:
($.50 per $ 1,000 af ne 't fee due on all permits.)
OWNER NAME: PHONE #: -
(AREA CODE)
TENANT NAME (IIvIl'ROVEMENTS ONLY):
INSTALLER:
ADDRESS: PHONE #: -
(AREA CODE)
CTTY: STATE: ZIP:
SIGNATURE OF PERMITTEE
? - ?
. ?, ..
/0-- ?-r
EAGAN T0WNSHIP
3795 Pilot Knflb Road
St. Paul, Minnesvta 55111
Telephoc?e 454-5242
PERMf x FOR WATER 3ERVICE CONNElCTI4N
Date•
• _... ..?.,?.
BilIing N=e
4wtxer:
Plumbeac:
Locatiior? of Conxrection
9/19f72
Meter No.? Pexmit Fee 10.00 d 2412
Meter Reading- Meter Dep. • Qpd 9/19/72
Meter Seg3.ecl: Yes I Add' I Chg.
? I Tata 1 Chg.
Inspected by
Bti1ldi.i3g is a:
Reaidextce_14
24u.ltiple No. tTnits
Ccmonnercia 1
Industrial
Qther
Number• ? 990
? ? ?
Site Address•
Billing Address
Meter Size."I Canaecti.oa
Date
Ramarks;
..t..?LJ EE 1Oli
tWiPROPER'-Y INSTALLED METERS.
Hy:
Chief TnspecCor
Ia cunaicieratioa caf the issue and delivexy to me of the abave permiti, I
hereby agree to do ttae proposed work in accordaaace with the ruiea aad
regulations of Bagan Township, Dakota County, M3.nMe e.
Please noCifq the above office when ready for inspecCion and cozmecti.aa.
/6 -c-i- y
$AGAN TCIWNSHIP
3795 Filot Itnob Raad
5t. Paul, Minnesota 55111
Telephone 454-5242
PI?lIT F0R S?4+lER SERVICB CqNNEC'TION
n A? : ? NUMER 1148
. 1 IOWNER. ' ,
Address- • ? L?.
,
PLUM$ER TYFE QF PIPE
?
DESCRIPTZON QF BUZLDTNG
Iiad.ustrial I Comercial I Residential I MulCiple DwelLfng ( No. of units
LoGatioti Of COtineCtioiis:
conneceion cnarge $260.0o pa. 9/1 9/72
Permie Fee 10.00 pd 9419/72
' 0 pd91972 sfc
SCreet Regairs
Tota 1
Inspected by:
Date
Rema rks :
By
ChieF Inspector
In consideratian o€ the issue anci deliaery ta me of the abave permit, I
hereby agree tv do the propased wortt in accordance with the ruies and
regulations of Bagasx Toc•mship, Datcota ounty, Minnes a
8
Please notifp whea ready for iaspectivn attd cannection and befare any portinn
Qf the work ia covered.
/
. --
MASTER CARD
LOCATION ,???e/? a??? Q?? J-9 9
OWNER ?L4a ????_?yAW0io,
STRUCTURE AND q
LAND USED AS /,Cx ,•???? ?(/ X
T-
Permit
No.
Issued I Issued To
Contractor Owner
BUILDING
PLUMBING ??99 7 1_ s?/?ilc
CESSPOOL - SEPTIC TANK
I
WELL
ELECTRICAL I
HEATING
GAS INSTALLING
SANITARY SEWER
O7HER
OTHER
Items
FOOTING
FOUNDATION
FRAMING
FINAL
ELECTRICAL
HEATING
GAS INSTALLATION i
SEPTIC TANK
i !'ESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER r
COMMENTS:
Approved
(Initial) Date
o- Y-23 I ", ,
Remarks Distance From Well
• SEPTIC
I CESSPOOL
TILE FIELD FT.
DEPTH
OF WELL
Violations Noted
on Back
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
08SERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
DATE OF INSPECTION
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
NON-COMPIIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
a COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
ITEMIZED AND DESCRIBED AS FOLLOWS:
17 REINSPECTION REQUIRED
DATE OF REINSPECTION
REINSPECTION REVEALED
CERTIFICATION - I certify that I have carefuily inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
F-I ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR
COAAMENTS:
DATE
23
?
i
MASTER CARD
LOCATiON
OWNER
Date
STRUCTURE AND
LAND USED AS
Permi#
No.
Issued issued To
Contractor Owner
BUILDING
PLUMBlNG
CESSPOOL - SEPTIC TAN1C
WELL
Ef.ECT2ICAL I
HEATING
GAS INSTALEING ?
SANITARY SEWER
oTHEa
OTHER
`I
e)
Items
FOOTING
POUNDATEQN
FHAMING
FINAL
ELECTRICAL
HEATING
GAS fNSTALLATION
SEPTIC TANIC
CESSPOOL
DRAI NFI ELD
RLUM8ING
WELL
SANITARY SEWER
COMM E N T5:
Approved
(Initial)
~27` X",
Remarks
Distance From Well
5E PTI C
CESSPpOL
°,70- 7 Y TILE FIELD FT.
- a cl -
.
? ?o
DEPTH
OF WELL
Violations Noted
on Back
4*
CUMPLIANCE INSPECTI4N REPORTS
i0 8E USEO ONLY !N EVENT OF 09SERVED YIOLAT101+i5
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INkSPECTION
NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
ACCEPTABLE 5LJSSTiTUTIONS OR
DEVIATIONS.
DATE OF INSPECTION
? IVON-COMPLIANCE. Bl11LDER WILL COMPLY
WITHOUT DELAY.
ITEMiZED AND DESCRIBED AS FQLLOWS:
? REiAlSAECTION REQUIRED
REINSPECTION REVEALED
? NON-COMPE.IANCE. BUILDER DC)ES NOT
INTEND TD COMPLY.
? CDMPLETION QF CERTAIN IMPR4VEMENTS
WILL 8E DELAYED BY CONDITIONS BEYOND
CONTROI.
DATE OF REINSPECTION
CERTI FICATION - I certify that I have carefully inspeeted the above in which I have no interest present or prospec#ive, and that I have reported herein
all significant conditions ok;served to be at variance with ordinances of the Tawn of Eagan, approved plans and specifiocations, and any specific require-
ments for off•site improvements relating to the property inspected.
F] ALL IMPROVEMENTS ACCEPTABLY C4MPLETED
BIJILDING INSF'EGTOR
COMMENTS:
DATE
cj? 0 3
Date:
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Resident/
Owner
Use BLUE or BLACK Ink
For Office Use
!
Permit #: ' 45-5
'
Permit Fee: (47 s ' !
Date Received: a- 1 - 13
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
/ 3 Site Address: 323S e4j Ci/e(4' Unit #:
Name: (-6 b,(2_4."/Am 4s 4 Phone: 451
Address / City /Zip:((( 3Tx‘ / 14 ag_CCQ-'(/i( AA( ,516-1
� r
Applicant is: Owner
Type of Work
Contractor
Description of work:
Construction Cost:
Contractor
dw�'J /Lna6,a
5DO
Multi -Family Building: (Yes / No y )
Company: L3Od.. CONSI J Contact: :--1-d
Contact:
t� n
Address: is r0 3 1 6,19 Atbrir -t/1-41( City: iose.A.,det /l}r
State: �S`b Phone: CG' -J/ ` 4://
/
License #: � 633 c j)-- Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
Crew a4
GA\A-
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota Stat
days of permit issuance.
x
uilding Code must be completed within 180
Applicant's Printed Name Ap lip cant'
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
Single Family
Multi
01 of Plex
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% " )
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
Porch (3 -Season)
'›, Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Interior Improvement Siding
Move Building Reroof
Fire Repair Windows
Repair Egress Window
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
24.
Foundation
Drain Tile
Roof: _Ice & Water _Final
Framing
Fireplace: _Rough In _Air Test _Final
Insulation
Sheathing
Sheetrock
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
)° Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Other:
Pool: _Footings Air/Gas Tests —
Siding: _Stucco Lath _Stone Lath
Windows
Retaining Wall: _ Footings _ Backfill Final
Radon Control
Erosion Control
, Building Inspector
Final
Brick
0(?/-: (0(
„*yr Kon On.n Ta F00050000
/69a5S
Psg 1 1
0 'ry
: MOW a.: 7.33 PN
'3930 akicithawle..
PLAT DRAWING
Insp. Dat*; 4/3/00 Insp. By: PCT
MR. & MRS. KENNETH MIA
MS MAMA* COM
EMW,MN56122 i
- Property Address: $9$1 BLACKHAWK CIRCLE, EAGAN
ORUM
Lost: LOT 10. atom 2. CEDAR GROVE NO. e
.a
O4►
Suarsias
�o oSz tvt
6 d d i'i'i
1" 90'
BLADKHAVWK
`ROLE.
ice. = . 32 A Cir -6 1393 9 se� -C-{
t0 4iu= Ani- se4-6.0).K.
.64sM s :as L'r 1 / m a
2..oz skoo f‘64 etcct gel ei<-
A -4l 0• RKEA L� 7izo s sed Add, -41) 2 -145 -To = oZSSa`
� f
�oo� irk 4 °T Propose.(. G&; Liokt cuo a Fr
'*
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLU or BLACK Ink
For Office Use
Permit#: (0el5()
Permit Fee: (B(p°
Date Received: 31( 5113
Staff:
2013 RESIDENTIAL PLU,LB�NG IERMIT APPLICATION
Gl w L^ �' n
Date: 3,75 �` / 3 Site Address: 5q, -SS
Tenant:
Suite #:
Resident/Owner
Contractor
Name:
15C/k
Phone:
Address / City / Zip:
�� i V� Ci,
Name:
uJe4'AR)
I
Address: /10 �� , V
License #:
City:
State: 1/14. ik) Zip: 5100.7. ( Phone:
Contact:61/4"-C.- 6 -42 -
Email: S k A) e
Type of Work
el -2w ga0(
New _ Replacement _ Repair _ Rebuild !Modify Space _ ork in R.O.W.
Description of work: RG vt'tt7r-�f M
-e' at.4—I'
Permit Type
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures (V Main /
Water Turnaround
Lower Level)
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
"Water Turnaround (add $189.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to st-rt witho t a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of .fans. /
r ktzei
x e'k �.- x dr'/ 0I,
Applicant's Printed Name Applica is Sig n r- i
FOR OFFICE USE
Reviewed By:
Date:
Required Inspections: _Under Ground _Rough -In _Air Test _Gas Test _Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113061
Date Issued:08/28/2013
Permit Category:ePermit
Site Address: 3938 Blackhawk Cir
Lot:10 Block: 9 Addition: Cedar Grove 8th
PID:10-16707-09-100
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
William Krech
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Corey R Baisch
3938 Blackhawk Cir
Eagan MN 55122
(651) 788-1193
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA128170
Date Issued:10/28/2014
Permit Category:ePermit
Site Address: 3938 Blackhawk Cir
Lot:10 Block: 9 Addition: Cedar Grove 8th
PID:10-16707-09-100
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Ashley Orman
130 Plymouth Ave N
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Corey R Baisch
3938 Blackhawk Cir
Eagan MN 55122
(651) 456-5755
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA137926
Date Issued:07/29/2016
Permit Category:ePermit
Site Address: 3938 Blackhawk Cir
Lot:10 Block: 9 Addition: Cedar Grove 8th
PID:10-16707-09-100
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Corey R Baisch
3938 Blackhawk Cir
Eagan MN 55122
Twin City Fireplace & Stone Company
6521 Cecilia Cir
Minneapolis MN 55439
(952) 232-1840
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA155156
Date Issued:04/30/2019
Permit Category:ePermit
Site Address: 3938 Blackhawk Cir
Lot:10 Block: 9 Addition: Cedar Grove 8th
PID:10-16707-09-100
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Corey R Baisch
3938 Blackhawk Cir
Eagan MN 55122
(651) 788-1193
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(641) 670-7051
Applicant/Permitee: Signature Issued By: Signature